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Keeping your kidneys healthy

Lisa M. Davila, B.S.N., M.S.

Created date

February 14th, 2019

Your kidneys work hard filtering your blood and maintaining the balance of fluids, nutrients, and waste products in your body. Did you know your kidneys process about 40 gallons of fluid every 24 hours?

You know how to keep many major organs in your body healthy. Your heart, brain, and lungs are among them. But do you ever think about your kidneys? According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), about 10% of adults in the U.S. have at least some kidney damage.

The kidneys’ job

These fist-sized organs located on either side of your spine in the middle of your back have the main job of filtering your blood and maintaining the balance of fluids, nutrients, and waste products in your body. Tiny filters, called nephrons, route the water and nutrients you need into your bloodstream, and waste products and extra fluid are sent to the bladder to be flushed away.

They also produce essential hormones that help control your blood pressure, manufacture red blood cells, and activate vitamin D.

Age-related changes tend to have a mild effect on kidney function, but even if one isn’t doing the job, the other will usually pick up the slack.

Causes of kidney failure

When kidneys are affected by disease, the nephrons stop functioning or die. Extra water builds up in your system, toxins are not filtered out, and with hormone production interrupted, your blood pressure can soar and you can become severely anemic.

Kidney disease can strike quickly—called acute kidney disease, usually due to injury or a toxic substance—or, much more common, it can come on slowly, which is called chronic kidney disease (CKD). Seniors are at a much higher risk of CKD than acute kidney disease.

“The most common reasons for CKD in older Americans are high blood pressure and diabetes,” says George Hennawi, M.D., director of the department of geriatrics at MedStar Good Samaritan Hospital in Baltimore, Md.

Those who are African American, or have a family history of heart disease or kidney failure, may be at increased risk.

Treatment

Acute kidney disease can sometimes be reversed, once the injury or toxins are cleared up, but CKD has no cure. The goal of treatment is to slow progression of the disease.

People with CKD usually need dialysis—a treatment that filters water and waste products from the blood. Many people who have regular dialysis feel well and can continue with their regular routine. It can, however, be a challenge sometimes to stay on track with your dialysis schedule.

Ultimately, the ideal treatment for people with end-stage CKD (called end-stage renal disease) is a kidney transplant, but not everyone is a candidate. In addition, there can be long waiting lists, and you have to take anti-rejection drugs as long as your new kidney is working.

Just because you are over 65 does not exclude you from being a transplant candidate. Statistics show that more seniors are receiving kidney transplants. According to the Mayo Clinic, in 2005, 14.5% of people on the transplant list were over age 65. But in 2015, that percentage rose to 22%.

Whether to have a transplant is a decision that involves many factors. “You need to consider your state of health, how well you function, your life expectancy, and what you define as a quality of life,” Hennawi says.

Protect yourself

Don’t wait for symptoms to appear, because unlike some other diseases, when your kidneys begin malfunctioning, you aren’t going to have any symptoms. In fact, according to NIDDK, you can lose almost 75% of your kidney function before you are even aware of it. Symptoms of severe kidney problems include fatigue, nausea, vomiting, and generalized itching.

Screening for CKD involves simple lab tests of your urine and blood. The urine test checks for a protein called albumin, which is typically absent if kidneys are healthy. The blood test estimates filtering ability (glomerular filtration rate, or GFR). If your GFR is below 60, your kidneys are not functioning properly, and if it is below 15, your kidneys have essentially stopped functioning.

Experts say if you have risk factors, you should know your GFR numbers the same way you keep track of blood pressure numbers. Like any disease process, catching CKD early can help slow its progression.

“Keeping underlying conditions such as blood pressure and diabetes under control can contribute dramatically to CKD prevention,” Hennawi says. “Monitoring your weight and adhering to a healthy lifestyle by following a low-salt, low-sugar diet and exercising can also help you prevent kidney disease.”

Other strategies for healthy kidneys according to NIDDK are to stop smoking, take medication as prescribed, get enough sleep, and find ways to manage stress or emotional health problems such as depression.

Important resources

American Kidney Fund

The American Kidney Fund’s mission is to help people fight kidney disease and live healthier lives. They provide programs and services including prevention activities, health educational resources, and direct financial assistance.